PROVIDENCE PHYSICIAN SERVICES CO


Address: 101 W 8th Ave, Ste 100 L-1, Spokane, WA 99204-2307
Phone: 5094745445

PROVIDENCE PHYSICIAN SERVICES CO (NPI# 1548587207) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1548587207
Entity Type Organization
Organization Name PROVIDENCE PHYSICIAN SERVICES CO
Other Organization Name PPS PSHMC PEDIATRIC SURGERY
Practice Address 101 W 8th Ave
Ste 100 L-1
Spokane
WA 99204-2307
Mailing Address 101 W 8th Ave
Mother Gamelin Center, 3rd Floor
Spokane
WA 99204-2307
Practice Telephone 5094745445
Enumeration Date 2010-04-21
Last Update Date 2011-02-18
Authorized Official Name ANSELMO NUNEZ (CHIEF EXECUTIVE)
Authorized Official Telephone 5094746616
Is Organization Subpart Y
Parent Organization Name PROVIDENCE PHYSICIAN SERVICES CO

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2086S0120X Surgery
Specialization: Pediatric Surgery
Allopathic & Osteopathic Physicians

Other Provider/Organization Names

Other Name Type Code
PPS PSHMC PEDIATRIC SURGERY Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1740566173 Providence Physician Services Co Internal Medicine 212 Central Ave Suite 440, Spokane, WA 99208 2011-10-31
1295016145 Providence Physician Services Co Family Medicine 801 W. 5th Ave, Suite 307, Spokane, WA 99204 2011-09-06
1619268281 Providence Physician Services Co Family Medicine 100 W. South Ave Chewelah, Chewelah, WA 99109 2011-04-29
1184915829 Providence Physician Services Co Family Medicine 5011 W. Lowell Ave, Seattle, WA 99208-8587 2011-04-28
1578869913 Providence Physician Services Co Family Medicine 12704 E Nora Ave, Ste B, Spokane Valley, WA 99216-1140 2011-02-02
1891001277 Providence Physician Services Co Pediatrics 5901 N Linderwood, Suite 126, Spokane, WA 99207 2010-08-24
1245557917 Providence Physician Services Co Obstetrics & Gynecology 518 Clay Street, Chewelah, WA 99109 2010-04-21
1215223953 Providence Physician Services Co Prosthetic/Orthotic Supplier 101 W 8th Ave, Mother Gamelin Center, 3rd Floor, Spokane, WA 99204-2307 2011-06-21
1336433812 Providence Physician Services Co Family Medicine 104 W 5th Ave, Suite 390e, Spokane, WA 99204 2011-06-02
1053618892 Providence Physician Services Co Internal Medicine 105 W 8th Ave, Ste 550e, Spokane, WA 99204-2302 2011-02-14

Other Data Sources

Entity Type Entity Name Entity Address
Washington State Corporations PROVIDENCE PHYSICIAN SERVICES CO. 1801 Lind Ave Sw, Renton, WA 98057-3368

Office Location

Street Address 101 W 8TH AVE
STE 100 L-1
City SPOKANE
State WA
Zip Code 99204-2307

Providers in the same location

NPI Name Taxonomy Address Enumeration
1003819319 Sacred Heart Medical Center General Acute Care Hospital 101 W 8th Ave, Spokane, WA 99204-2307 2005-05-31
1124626841 Melissa Ann Benson Respiratory Therapist, Registered 101 W 8th Ave, Spokane, WA 99204-2307 2020-10-14
1184236671 Margaret Ann Warren Physical Therapist 101 W 8th Ave, Spokane, WA 99204-2307 2020-08-18
1265044747 Melyssa Carlson Registered Nurse 101 W 8th Ave, Spokane, WA 99204-2307 2020-08-17
1760091276 Corle Morefield Pharmacist 101 W 8th Ave, Spokane, WA 99204-2307 2020-07-30
1174143663 Ashley Kay Gardiner Student in an Organized Health Care Education/Training Program 101 W 8th Ave, Spokane, WA 99204-2307 2020-04-24
1265061485 Mary Katherine Griessmann Social Worker 101 W 8th Ave, Spokane, WA 99204-2307 2020-04-08
1558990994 Ingrid Mary Agnew Social Worker 101 W 8th Ave, Spokane, WA 99204-2307 2020-04-07
1952930562 Cody Key Student in an Organized Health Care Education/Training Program 101 W 8th Ave, Spokane, WA 99204-2307 2020-04-06
1417586173 Samuel Logan Student in an Organized Health Care Education/Training Program 101 W 8th Ave, Spokane, WA 99204-2307 2020-04-05
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1982250957 Megan Elizabeth Dibenedetto Pharmacist 105 West 8th Avenue, 350e, Spokane, WA 99204 2019-08-14
1619521168 Evelyn R Cabon Genetic Counselor, MS 101 W. 8th Avenue Suite 1100, Spokane, WA 99204 2019-08-01
1346700655 Christina Rose Student in an Organized Health Care Education/Training Program 120 W. 8th Avenue, Spokane, WA 99204 2019-03-22
1508339862 Cody J French Physical Therapist Washington Outpatient Rehab, 507 S Washington, Spokane, WA 99204 2019-01-09
1730655598 Washington Outpatient Rehabilitation, LLC Physical Therapist 507 S. Washington St., Suite 10, Spokane, WA 99204 2018-10-19
1013405547 Joel James Hayden Student in an Organized Health Care Education/Training Program Providence Sacred Heart, 101 West 8th Avenue, Spokane, WA 99204 2018-04-30
1144694787 Brooksjohnsonpllc Dentist 1004 S. Monroe Street, Ste 100, Spokane, WA 99204 2015-11-19
1497184196 Kathalene M Cassels Physician Assistant 810 W. 5th Ave. Ste 510, Spokane, WA 99204 2013-11-04
1174880454 Kelly E Wurzel Psychiatry & Neurology 624 E. Front Ave, Spokane, WA 99204 2012-04-11
1003190331 Katie L Gomez Nurse Practitioner 805 W. 5th Ave, Suite 518, Spokane, WA 99204 2011-10-05
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Taxonomy Information

Taxonomy Code 2086S0120X
Grouping Allopathic & Osteopathic Physicians
Classification Surgery
Specialization Pediatric Surgery

Taxonomy Definition

A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1003840398 Paul C Thorne Surgery 101 W 8th Ave, Ste 100, Spokane, WA 99204-2307 2006-07-10
1730119694 Diane W Mccarthy Surgery 101 W 8th Ave, Ste 100, Spokane, WA 99204-2307 2006-07-04
1205887122 James D Fischer Surgery 101 W 8th Ave, Ste 100, Spokane, WA 99204-2307 2006-05-15
1801855408 Winston Chan Surgery 101 W 8th Ave, L1 Ste 100, Spokane, WA 99204-2307 2006-03-22

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1235366378 Caitlin Smith Surgery 4800 Sand Point Way Ne # Oa9.220, Seattle, WA 98105-3901 2009-06-16
1487690889 John Daniel Horton Surgery Madigan Army Medical Center 9040 Fitzsimmons, Tacoma, WA 98431-2170 2006-06-22
1710972336 Loren Mason Cobb Surgery 3013 S 363rd St, Federal Way, WA 98003-7249 2005-09-20
1427258094 Samuel Emlen Rice-townsend Surgery 4800 Sand Point Way Ne, Seattle, WA 98105-3901 2007-07-23
1508065046 David H Rothstein Surgery 4800 Sand Point Way Ne, Seattle, WA 98105-3901 2007-07-14
1770792707 Sara K. Rasmussen Surgery 4800 Sand Point Way Ne, Seattle, WA 98105-3901 2007-05-22
1215002944 Patrick J Healey Surgery 4800 Sand Point Way Ne, Seattle, WA 98105-3901 2006-11-21
1700967064 Robert S Sawin Surgery 4800 Sand Point Way Ne, Seattle, WA 98105-3901 2006-10-17
1033290390 John H T Waldhausen Surgery 4800 Sand Point Way Ne, Seattle, WA 98105-3901 2006-10-17
1083704977 Daniel James Ledbetter Surgery 4800 Sand Point Way Ne, Seattle, WA 98105-3901 2006-10-13
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Competitor

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City SPOKANE
Zip Code 99204

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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